Provider Demographics
NPI:1073277273
Name:HONG, GRACE (PHARMD, MBA)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:HONG
Suffix:
Gender:F
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N GARFIELD AVE STE 107A
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1167
Mailing Address - Country:US
Mailing Address - Phone:626-288-6560
Mailing Address - Fax:626-288-6481
Practice Address - Street 1:600 N GARFIELD AVE STE 107A
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1167
Practice Address - Country:US
Practice Address - Phone:626-288-6560
Practice Address - Fax:626-288-6481
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist